Why You Should Practice Using Different Types of Hemostatic Agents

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By Tim Nowak for EMS1 BrandFocus

Excessive bleeding…check!

Discuss bleeding control with your teams and train providers on both how to physically control bleeding and how to incorporate the various hemostatic agents your agency has available.

Discuss bleeding control with your teams and train providers on both how to physically control bleeding and how to incorporate the various hemostatic agents your agency has available. (Getty)

Open the packaging of the haemostatic agent…check!

Now what?

Has this been the extent of your agency’s hemostasis deployment training and product discussion? What about hands-on training on how to use the products you buy – especially those that seem to challenge what we’ve been traditionally taught (i.e. not to cram anything into someone’s body)?

Training with hemostatic agents can be a bit tricky.

WHAT DO YOUR SUPPLIERS KNOW ABOUT HAEMOSTATIC AGENTS?

Here’s a little experiment to try: In a classroom setting, use whatever simulator you have to replicate a major hemorrhage and give your participants a few different hemostatic agents to use to control the hemorrhage. Do not ask them or explain to them how the product is supposed to be used. Start by letting them figure it out, then see what kind of results you get.

  • Did they just apply the dressing to the site or did they pack it into the wound?
  • What about direct pressure? Did they hold it firmly in place and wrap it with a gauze roll or bandage over it, or did they firmly press the wound and the haemostatic gauze for at least 60 seconds, or until Is Bleeding Controlled?
  • What about folding hemostatic gauze in half before packing it into a wound – does it make sense to do so?

Which answer is the correct answer? Well, it depends on what you’re using.

WRAP AND PRESS TO STOP BLEEDING

Many static training environments simply do not replicate the presence of major bleeding (exsanguination). A puddle of fake blood on a mannequin’s abdomen is not at all realistic. A bag of liquid under a little pressure as it expels concentrated red liquid until the “wound” is sufficiently compressed is an entirely different training situation.

Replicating a situation where the use of hemostatic agents is indicated – followed by how to properly wrap and press these products into the wound – is the training approach we need to instill and embed into the muscle memory of our providers. It is equally important to understand the nuances between each specific product – how it is designed to be used (packaged).

Again, it goes against traditional education to talk about packing any type of dressing in someone gets hurt, but under those circumstances, and with those products, that’s exactly what you’re supposed to do.

The QuikClot EMS Starter Pack provides tools to help promote faster bleeding control for a variety of injuries encountered in the field.

The QuikClot EMS Starter Pack provides tools to help promote faster bleeding control for a variety of injuries encountered in the field. (Bound Tree Medical)

What types of injuries might this apply to? Here is a list of likely suspects requiring aggressive bleeding control:

  • Gunshot or stab wounds to the abdomen.
  • Gunshot or stab wounds to the extremities (when a tourniquet is not indicated, or in conjunction with them).
  • Impalements.
  • Large lacerations.

SET UP YOUR TRAINING (AND YOUR TRAUMA BAG) FOR SUCCESS

The right tool is of no use to you if you don’t know where it is or if you can’t access it when you need it. This certainly applies to hemostatic agents. Storing them all in the back of a cupboard inside your ambulance does little good for your crews (or patients).

Critical equipment such as hemostatic agents must be easily accessible on the patient side. When incorporating the use of the product into your training scenarios, don’t just lay out everything needed to perform the call on a table – put in a replica training bag in the same place, in the same packaging and with the same misaligned pulls and zippers as your everyday bags and train like you’re working out.

TRAIN REALLY, TRAIN OFTEN

Working in pairs, start with the first provider applying direct pressure to a bleeding wound with their gloved hands. Then introduce a sterile dressing, followed by a hemostatic agent. Pack the wound, apply direct pressure, then switch providers, maintaining firm, direct pressure throughout the process.

This type of training should not be limited to a one-time event. We (you) need to talk about bleeding regularly and train providers on both how to physically control bleeding and how to incorporate escalation tools like hemostatic agents to help keep leakage at bay.

Visit Tree linked for more information on hemostatic agents.

Read more : 3 Steps to Bleeding Control (not necessarily in order)

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